Headache Doctor in Weldon Spring, MO

WELDON SPRING, MISSOURI

Weldon Spring patients see our headache doctor at the Natural Bridge Road office, about 18.5 miles and roughly 27 minutes via Highway 94 and I‑70. The first visit establishes whether the neck is contributing, whether it is the primary source or a secondary one, and what the next confirmatory step is.

A headache that starts at the base of the skull and spreads forward over one side, that is reproducible by pressing the upper neck and provoked by holding one head position, is coming from the cervical spine. It is one of the few headaches with a confirmable source.

Getting here from Weldon Spring

Weldon Spring is about 18.5 miles from Natural Bridge Road, roughly 27 minutes via Highway 94 and I‑70 east. Patients arriving from here with neck‑driven headache frequently note that the drive itself provokes it, which is diagnostically useful rather than incidental.

How can a neck problem cause a headache?

The upper three cervical nerve roots share second‑order neurons in the brainstem with the trigeminal nerve, which supplies the face and the front of the head. This convergence — the trigeminocervical complex — means a signal originating in the upper neck can be perceived in the forehead, the temple or behind the eye.

That is not a theory constructed to explain the symptom. It is established anatomy, and it explains why stimulating structures at C1 through C3 in experimental settings produces referred head pain in predictable distributions.

The structures capable of it are the atlanto‑occipital and atlanto‑axial joints, the C2–3 facet joint, the upper cervical discs, and the suboccipital musculature. Cervicogenic headache covers the anatomy and the criteria.

How do you tell a neck headache from a migraine?

The features are reasonably specific, though overlap exists and the two frequently coexist:

• Side‑locked pain — it is always the same side, which migraine usually is not over time
• Onset at the occiput or upper neck with forward spread, rather than starting frontally
• Provocation by sustained neck position or by pressure on the upper cervical segments
• Reduced neck range of motion on examination, particularly rotation in flexion
• Absence of the full migraine symptom set — nausea and light sensitivity may occur but are usually milder
• Poor response to triptans, which is often what brings the patient in

That last point is worth stating. A headache that has never responded to adequate triptan dosing should prompt a look at the neck rather than a fourth triptan.

How is a cervicogenic headache diagnosed?

Imaging does not confirm it. Degenerative change in the cervical spine is present in most adults past forty and correlates poorly with headache, exactly as it does in the lumbar spine.

The confirmatory test is an image‑guided anesthetic block of the suspected structure — typically the C2–3 facet joint or the third occipital nerve, or a greater occipital nerve block where the presentation points there. If numbing the structure abolishes the headache for the duration of the anesthetic, the source is established.

That is diagnostic information rather than treatment, and it is the reason the block is worth doing even when the relief is temporary. Occipital nerve block and nerve block versus medication cover the logic.

Can you have a migraine and a neck headache at the same time?

A substantial number of patients have both. Migraine and cervicogenic headache coexist frequently, and each can lower the threshold for the other — cervical input sensitizes the trigeminocervical complex, and migraine produces neck pain in a majority of attacks.

That last fact causes a lot of misdiagnosis in the other direction. Neck pain during a migraine attack is a migraine symptom, not evidence of a cervical source. It is present in most attacks and it resolves with the attack.

The separation comes from the sequence. Neck symptoms that precede and provoke the headache point cervically; neck symptoms that arrive with the headache and leave with it are part of the migraine. Headache at the back of the head covers the differential.

How is cervicogenic headache treated?

Physical therapy directed at the upper cervical segments, deep neck flexor endurance and thoracic mobility is the foundation, and it does the durable work. There is reasonable evidence for manual therapy combined with specific exercise in this population.

Interventional treatment supports it rather than replacing it. A confirmed C2–3 source that recurs after diagnostic blocks may respond to radiofrequency treatment of the third occipital nerve. Occipital nerve blocks are useful for breaking a cycle and for patients with clear occipital tenderness.

Where the presentation is genuinely occipital neuralgia — electric, shooting, in the distribution of the greater or lesser occipital nerve, with a trigger point that reproduces it — that is a related but distinct diagnosis. Occipital neuralgia covers it.

What the first visit establishes

Whether the neck is contributing, whether it is the primary source or a secondary one, what has already been tried and at what dose, and what the next confirmatory step would be.

For a good number of patients the most useful outcome is learning that the headache they have been treating as migraine for years has a structural source that can be tested. What happens at a headache clinic describes the visit.

Frequently asked questions from Weldon Spring patients

My MRI showed cervical degeneration. Does that explain my headaches?

Not on its own. Degenerative change is present in most adults past forty and is found just as often in people with no headache at all. What establishes a cervical source is the clinical pattern plus a diagnostic block, not the scan.

Why do triptans not work for me?

Several possibilities, and a cervical source is one of the more common. Triptans act on migraine mechanisms; a headache generated by a cervical joint does not respond to them. Consistent non‑response to adequate dosing is a reason to revisit the diagnosis.

Can a chiropractor fix this?

Manual therapy has a role and there is evidence supporting it combined with specific exercise. What it does not do is establish the diagnosis. If manipulation has been tried repeatedly without lasting change, the useful next step is confirming the source rather than continuing.

I get neck pain with every migraine. Is that cervicogenic?

Usually not. Neck pain occurs in the majority of migraine attacks as part of the attack itself. The distinguishing question is whether the neck symptoms come first and provoke the headache, or arrive alongside it.

What is a cervicogenic headache?

It is a headache that comes from the cervical spine. It starts at the base of the skull and spreads forward over one side, can be reproduced by pressing on the upper neck, and is provoked by holding one head position. The upper neck nerves share brainstem pathways with the nerve that supplies the face and front of the head, which is how a neck problem is felt in the head.

Is a nerve block worth doing if the relief is temporary?

Yes, because the first block is a test, not the treatment. An image-guided anesthetic block numbs the suspected structure, usually the C2-3 facet joint or the third occipital nerve. If the headache disappears for as long as the anesthetic lasts, the source is established. That answer is what points treatment in the right direction, including radiofrequency treatment for a confirmed C2-3 source that recurs.

Can driving trigger a neck headache?

It can. Sustained neck positions are one of the classic provokers of cervicogenic headache, and many patients notice that a long drive brings it on. That detail is useful rather than incidental: a headache set off by holding the head in one position points toward the neck. Bring that observation to your first visit, along with what you have already tried.

What is the difference between cervicogenic headache and occipital neuralgia?

They are related but distinct. Cervicogenic headache is a referred ache that starts in the upper neck and spreads forward. Occipital neuralgia is electric and shooting, runs along the greater or lesser occipital nerve at the back of the head, and has a trigger point that reproduces it. Telling them apart matters because the next diagnostic and treatment steps differ.

Related reading

• Cervicogenic headache
• Occipital neuralgia
• Occipital nerve block
• Headache at the back of the head
• Nerve block vs medication